Deciding Guard or Reserves

[EugeneF]

I've seen this question asked a few times before, but there aren't too many responses besides a post from 2006.

I will be starting medical school in August, and after extensive research (and deciding against HPSP) I am deciding between joining the National Guard or the US Army Reserves for their medical student program. Here are some positives and negatives I can think of:

National Guard: Positives: Belong to an individual unit, get to know people in the unit better, serve as a primary care doc for this unit once I finish med school. It seems most combat arms units are with the ARNG, and I like the idea of being a primary care doc for a combat arms unit regardless of what specialty I choose. Financially: Get paid drill time while in college, state tuition financial benefits, and when in residency I can take STRAP and other financial incentives while still not extending my commitment past 8 years. There is also an ARNG med student recruiter program where I could get active O-1 pay for 2 or 3 years while I'm in med school. This might depend on my state's budget though. Cons: A recruiter told me that if I decide to change states, I'll have to repay the tuition benefits to the state I left. Is this true?

Reserves: Positives: Lots of benefits from being part of a larger organization rather than just the state. More deployment opportunities. MDSSP gives ~$2200 a month while in school, and I can stop once I graduate. I can get drill pay during school, but only if I actually go to drill. I can take STRAP during residency. Wouldn't have any payback past 8 years as long as I stop taking MDSSP after med school, and don't take other financial incentives. Cons: Since I wouldn't be part of a state unit, I have the feeling that it would be a lot less of a close nit feel as a doc with the AR rather than the ARNG. I would be doing whatever specialty I chose, and likely wouldn't be a GMO type doctor for a combat arms unit. It seems like the army reserves route would leave me feeling more disconnected from the actual military than would the Guard.

Is this accurate? Can anyone else give any input on which would be better to join as a medical student (with no prior service)? Any information would be greatly appreciated!

Also, from my research it seems that MDSSP for both Guard and Reserves has repayment beginning AFTER residency. However, the recruiter I spoke with today specifically told me that I can start repaying my commitment for MDSSP while I'm in medical school. Is this true?

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[jonb12997]

My understanding of the mdssp is that you are correct and that it gets paid back after residency. This is a change recently. Luckily my contract said the old way where it WAS paid back during residency and I had to call them on it. Long story...

As far as the other stuff, basically you're on the right track. I think that your experience is going to be very different in different states for ARNG. A big state like ca or tx is going to have different experiences than a smaller state. (Notice I didn't say better or worse). I can't speak to reserves at all...

Another little positive but if you join you can sign up for tricare while you're in school. Way cheaper than most med school insurances and way better converse than a lot of school's

 

[DeadCactus]

Unless you have brand new information, the ASR (AMEDD Student Recruiter) program is long gone and I can't imagine it coming back without major revisions. MDSSP, STRAP, and loan repayment are the major financial incentive and equal between Guard and Reserve. Many states have some educational benefits for National Guard members but the details of that are entirely state dependent and may include some sort of repayment if you leave the state.

MDSSP and STRAP both incur a 12 months of service for 6 months of stipend obligation that begins after residency. From PGY3 year and onward, you can take loan repayment in addition to STRAP.

You may not ultimately have a choice and be pushed into Guard or Reserve based on your specialty as some specialties only have billets in one component.

Ultimately, you've nailed the major differences.
NG: More combat arms units with unit PCP type work. State activation for disasters. Mostly deploy to aid and support stations.
Reserves: More support units. No state activation. Mostly activated to hospital settings and often outside the theatre of operations backfilling for physicians deployed to the theatre.

I chose the Guard because of the ASR program and would like to stay Guard for the state supporting missions. Ultimately, you have to figure out what you want to get out of the military which is hard to do with neither military nor medical experience.

 

[deleted480308]

You need to stop talking to whatever person told you the med student recruiter program exists. They may be well intentioned but good intentions don't have a section in your military contract

 

[notdeadyet]

National Guard: Positives: Belong to an individual unit, get to know people in the unit better, serve as a primary care doc for this unit once I finish med school. It seems most combat arms units are with the ARNG, and I like the idea of being a primary care doc for a combat arms unit regardless of what specialty I choose. Financially: Get paid drill time while in college, state tuition financial benefits, and when in residency I can take STRAP and other financial incentives while still not extending my commitment past 8 years.

MDSSP (which gives you financial benefits in medical school) and STRAP (which gives you financial benefits in residency) are both available to ARNG and Army Reserve. You incur 2 years for every one year you take the benefits if you do EITHER; if you do both, you only incur 1 year for every one year you take MDSSP. When you do payback, if you take both, the payback is consecutive, NOT concurrent.

I'm not sure what you mean about "not extending my commitment." Any incentive you take will increase your commitment.

Ex 1: Join without taking any incentives. Do medical school and a four year residency. You are free and clear 8 years after joining at the start of medical school.

Ex 2: Join and take MDSSP only (or take STRAP only). Do medical school and a four year residency. You will owe 8 years after completion of residency. You are free and clear 16 years after joining at the start of medical school.

Ex 3: Join and take STRAP AND MDSSP. Do medical school and a four year residency. You will owe 12 years after completion of residency. You are free and clear 20 years after joining at the start of medical school.

 

[notdeadyet]

OP- Your other impressions are pretty right on. There tends to be less bureaucracy with ARNG vs. AR just because everything is done in-state. This can be an advantage or a disadvantage, depending on you and your state. There is some stuff that is outside your control. If you end up doing a specialty the Guard doesn't use, you will have to transfer to the Army Reserve; this hardly ever happens in reverse.

Don't worry about "opportunity for deployment." There will be plenty, regardless of ARNG vs. AR.

The other posters are giving great info....

As far as the other stuff, basically you're on the right track. I think that your experience is going to be very different in different states for ARNG. A big state like ca or tx is going to have different experiences than a smaller state. (Notice I didn't say better or worse). I can't speak to reserves at all...

This. During my medical school and residency days, I was drilling a LOT. Command was flexible, but I was working hard. I'm in a big state (CA). Colleagues at smaller states definitely seemed like what a lot of big Army stereotypes the Guard as (drill consisting of cook-outs and whatnot) and these folks seemed to be able to just show up in uniform and study for the weekend. Your mileage will vary.

Another little positive but if you join you can sign up for tricare while you're in school. Way cheaper than most med school insurances and way better converse than a lot of school's

This will also vary. Tricare pays out like Medicaid and many providers avoid it like the plague. If you're near a big military presence (active or retired), you may have better luck, but in many locations, you'll be hard pressed to find providers who take it.

You need to stop talking to whatever person told you the med student recruiter program exists. They may be well intentioned but good intentions don't have a section in your military contract

This times 10. Anyone who tells you about ASR is about 6 years behind in the times. Avoid them.

 

[EugeneF]

Thanks everyone for the replies. I will be joining either the NY or PA guard. Can anyone share some experiences with either of these states?

So two more questions:
One, the reserves recruiter told me that reserves officers can frequently so all their yearly training at once since it can be difficult getting off for a weekend as a doctor. Has anyone heard of the guard doing this as well?

Two, w/o taking MDSSP/STRAP I can expect to take in ~$390/mo drill pay, ~$380/mo GI select reserves pay for 36 mo's, and if my state has specific guard benefits, then I can get those. This is the max I'd make without taking other financial incentives. Am I correct in this assumption?

 

[notdeadyet]

One, the reserves recruiter told me that reserves officers can frequently so all their yearly training at once since it can be difficult getting off for a weekend as a doctor. Has anyone heard of the guard doing this as well?

First, I'd suspect your recruiter is FOS. Ask him for a Army Reserve physician who does this that you can speak to directly. Cue tumbleweeds.

The Reserve Corps (which includes Army Reserve and Guard) tends to be very flexible with physicians and drilling. But I doubt they'd allow you do to "all of their yearly training at once." It's pretty common to miss a drill here and there and make it up when it's convenient, but not a whole year.

Also, you are not going to find a residency program or employer that will support taking 39 days off at once (which is roughly what a whole year of drilling would amount to when you include annual training). Plus, the Army requires periodic attendance at drills for things like physical fitness tests, physical exams, etc.

Two, w/o taking MDSSP/STRAP I can expect to take in ~$390/mo drill pay, ~$380/mo GI select reserves pay for 36 mo's, and if my state has specific guard benefits, then I can get those. This is the max I'd make without taking other financial incentives. Am I correct in this assumption?

Your drill pay is going to get higher than that as you stay in the Guard. You should be eligible for any specific state benefits. But note that state benefits (if you're thinking of free medical school) are sometimes more limited. Many have fine print that indicate the tuition benefit is free cost of undergraduate in-state tuition, which tends to be a small fraction of medical school attendance.

You will not be getting the GI Select Reserve pay, so far as I know. For officers, this requires that you incur a 6 year drilling obligation IN ADDITION to the 6 year drilling obligation you get when you sign. See more details at:
http://www.benefits.va.gov/gibill/mgib_sr.asp

 

[EugeneF]

First, I'd suspect your recruiter is FOS. Ask him for a Army Reserve physician who does this that you can speak to directly. Cue tumbleweeds.

The Reserve Corps (which includes Army Reserve and Guard) tends to be very flexible with physicians and drilling. But I doubt they'd allow you do to "all of their yearly training at once." It's pretty common to miss a drill here and there and make it up when it's convenient, but not a whole year.

Also, you are not going to find a residency program or employer that will support taking 39 days off at once (which is roughly what a whole year of drilling would amount to when you include annual training). Plus, the Army requires periodic attendance at drills for things like physical fitness tests, physical exams, etc.

Your drill pay is going to get higher than that as you stay in the Guard. You should be eligible for any specific state benefits. But note that state benefits (if you're thinking of free medical school) are sometimes more limited. Many have fine print that indicate the tuition benefit is free cost of undergraduate in-state tuition, which tends to be a small fraction of medical school attendance.

You will not be getting the GI Select Reserve pay, so far as I know. For officers, this requires that you incur a 6 year drilling obligation IN ADDITION to the 6 year drilling obligation you get when you sign. See more details at:
http://www.benefits.va.gov/gibill/mgib_sr.asp

Thanks for all the answers! I'm going to speak with a Reserves doc next week, and am trying to find a Guard doctor to speak with. I guess now I just need to decide if I want to see myself supporting a unit doing GMO duties like physicals, or being part of a military hospital maybe doing more of my actual specialty. My main motivation is being part of the Reserve Corps rather than the tuition benefits (though of course those would be nice), so I have some thinking to do. Thanks again.

 

[notdeadyet]

I guess now I just need to decide if I want to see myself supporting a unit doing GMO duties like physicals, or being part of a military hospital maybe doing more of my actual specialty.

Definitely talk to docs on both sides and hear what their drill looks like.

You might be overestimating what Army Reserve drill looks like. From talking to Reserve colleague, it sounds a lot like mine in ARNG. Their hospitals become practicing entities when they are deployed. They do not have stateside hospitals functioning (at least not out my way). Do not anticipate that you will be practicing in a functioning hospital in either the Reserve or Guard.

That said, as Army Reserve tends to do more stateside backfill deployments vs. Guard tending to do more overseas combat deployments, maybe some units have you drill at a nearby Army base from time to time. It'll be interesting what you hear. Feel free to post.

 

[DrBacchi]

Definitely talk to docs on both sides and hear what their drill looks like.

You might be overestimating what Army Reserve drill looks like. From talking to Reserve colleague, it sounds a lot like mine in ARNG. Their hospitals become practicing entities when they are deployed. They do not have stateside hospitals functioning (at least not out my way). Do not anticipate that you will be practicing in a functioning hospital in either the Reserve or Guard.

That said, as Army Reserve tends to do more stateside backfill deployments vs. Guard tending to do more overseas combat deployments, maybe some units have you drill at a nearby Army base from time to time. It'll be interesting what you hear. Feel free to post.

It sounds like the deployment opportunities are more interesting in the Guard, can you specifically request for a overseas combat deployment?

I understood that NG and Reserves are the only way to get into the Army as a permanent resident. How do you transfer from the Guard to active duty (after naturalization ofc)? Can you be a full-time NG doc?

 

[deleted480308]

It sounds like the deployment opportunities are more interesting in the Guard, can you specifically request for a overseas combat deployment?

I understood that NG and Reserves are the only way to get into the Army as a permanent resident. How do you transfer from the Guard to active duty (after naturalization ofc)? Can you be a full-time NG doc?

You would need guard permission to leave and transfer to active duty. But if you just want to keep deploying forever you can keep volunteering to go...I don't think you will though

 

[lambchopnavy]

MDSSP (which gives you financial benefits in medical school) and STRAP (which gives you financial benefits in residency) are both available to ARNG and Army Reserve. You incur 2 years for every one year you take the benefits if you do EITHER; if you do both, you only incur 1 year for every one year you take MDSSP. When you do payback, if you take both, the payback is consecutive, NOT concurrent.

I'm not sure what you mean about "not extending my commitment." Any incentive you take will increase your commitment.

Ex 1: Join without taking any incentives. Do medical school and a four year residency. You are free and clear 8 years after joining at the start of medical school.

Ex 2: Join and take MDSSP only (or take STRAP only). Do medical school and a four year residency. You will owe 8 years after completion of residency. You are free and clear 16 years after joining at the start of medical school.

Ex 3: Join and take STRAP AND MDSSP. Do medical school and a four year residency. You will owe 12 years after completion of residency. You are free and clear 20 years after joining at the start of medical school.

Is payback in the form of active duty or residency?

 

[deleted480308]

Is payback in the form of active duty or residency?

Mdssp and strap paybacks are time in the guard after residency